253 NE 100 St (3)MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
A eLvw e t CLU G,LC U Y1 n V Ov
DATE: rehrucLry f - 00 Q S 7 �� ( 3
OWNER'S NAME: a ... ,• A PHONE: L 7 _
ADDRESS: ■ V ' " e` ssrexxxxae
iexxxxxx,
s.
APPROVED:
x
X
X
ADDRESS OF SITE: 0 , 'A N 4 Es 4 l o O d-re (
CONTRACTOR & LICENSE (if applicable) N I 1
COMPANY NAME: — PHONE: —
*** %7CC >,C X ft >,C )C 7CC * )k yt Ytxxx xx>4>4 *x x X x xxx )C}C )$ x )C xxxx x*>4 xXxxxxxx x)4
All Elements on the site must be listed and indicate the color to bs
Walls r01 — 5,m, e Vi 0- 1
�.
VI.i../
Fascia
Drip Cap/Drip Edge
Soffit
Roof /•1
Flower Bins
Shutters
Awnings
Chimney
Doors and door jams � .,1-ertreA
Garage Doors - 1 a
Railings v o,,4- s rk C rCi.A
Fences
Decorative Metal
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory Buildings � l , aral e � c�v a l
Other
OWNER'S AFFIDAVIT: I certify that all the foregoing informatiol
and that all work will be done in compliance with all applicable laws
construction and zoning. I authorize the above -named contractor, if
do the work stated. Furthermore , the paint colors wil be as per the a
G
rp s h IA (t y
TV\ 74
Building OffiX Date .
kcx *xxxx?Cxx xxxx
wary
r\.3
kAp‘Rers
9ZLZ ®3"ao
OS LZ
0
3
-Ft
09 L Z
0
0
0
Signature of Owner Da Signature of Contractor Date
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
0�.
4/23/01
•
fi
Village of Miami Shores
10050 NE 2nd Avenue
Miami Shores, FL 33138
Phone: 305 - 795 -2204
Printed: 2/21/2002
(D Applicant: ANDREW
Owner: HUNTINGTON
Contractor
Local Phone:
Parcel # 1132060134680 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 18 & 19 BLK 34
Job Address: 253 NE 100 ST
Fees:
FEE2002 -1032:
FEE2002 -1033
FEE2002 -1034
Permit Status: Approved
Work: EXTERIOR P1
If there is no permit p
fee is $50.00, which. mu:
This Permit is granted to the,
ordinances pertaining thereto ar
and approved by the proper. mw
authorization. A further.conditio
ordinances and regulations pert -
by his agents, servants - or emplc
Signed:
In consideration of the issuance
with the plans, drawings,"statem(
myself, my agent, servants or err
•
veA
D cription
Fee
CCF
Notary Fee
Total Fees:
Address:
Cellular:
Permit Expiration:... _ 8/20/2nm
PAY TO THE Miami Shores Village
ORDER OF
/K7 » ,X v e
MEMO paint permit
ANDREW L. HUNTINGTON
CLAUDIA H. HUNTINGTON
253 N.E. 100TH STREET
MIAMI SHORES, FL 33138
Miami•Shores Village
10050 N.E. Second Ave.
Miami Shores, FL 33138 -2382
Building Permit
Permit Number: BP2002 -359
HUNTINGTON
ANDREW
Amount
6x900
$0.60
$5.00
$10.60
Page 1 of 1
Total Fees: $
Total Receipts: $0.00
MIAMI FIREFIGHTERS
FEDERAL CREDIT UNION
PAY THRU SUN BANK
MIAMI, N.A.
63- 8037/2660
1:2660803? 21:90 L0000044 L060u■ 2840
11/13/2001
1$ 6C
2840
DOLLARS 8
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY.
TYPE
Generator
QTY.
TYPE
Refrigeration, Tons
QTY.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
'I'YI'E
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
D TE
Zoning
ae2 /3��
"2 ?J -G /Od
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
r -
9
mil"z..12-
Building Official
Page 4
OFFICE USE ONLY
CIIECKLIST
O OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
O OTHER
(Specify & Attach)
❑ IMPACT FEE
(New Construction)
PER\IIT PEES
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
$6
Metropolitan Dade County (C.C.F.) $ e 0
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
❑ PROOF OF OWNERSHIP
(Attach)
• HRS / DERM APPROVAL
(Septic / Sewer)
❑ OTHER
(Specify & Attach)
$
ISSUING OFFICIAL
5,0o
(sq.ft. = x/1000
x ¢.60)
(¢.005 / sq.ft.)
(¢.01 /sq.ft.)
REVIEWED AND PREPARED BY:
PERMIT APPLICATION
O CONDO ASSOCIATION APPROVAL
(Attach)
O BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL
Sa 0
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
PROPERTY OWNER
New Construction
Name , Q � J J
// n/ d e . 6IN I71W 4t/ "i A f O"
Address25-3 Al / .(me' !� 7
," i4'vl; 5 `iGrtt , f'
33/3k
Home Telephone 3 a 5 .7 r _ o 9 1 e
Business Telephone 3 a 7 ? (e G / )
Fax 3 0 5" 7 s''') 5'S k 2
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
A PPLICATION
Job Address: 25 ,k/ g / (10 5 AA , AA; S ? U „fp F >) ( 3
Address Apt. City State v Zip
Folio Number //, 3a 04.04.3(.0 Fa Descri ption of Work P i 1 "' b6 `4-5" c
Lot Block
Subdivision PB PG
Current Use of Property - 1 .�7.t _..
Proposed Use of Property P k S e
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No. 21 ' 2-O() ,
Zoning Linear Feet
Square Feet Units Floors
Value of Work CAC" Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
Page 2
INIPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, Is' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
c ,2
1 \ Signature of Owner
/ C 't
Print Name I Print Name
' �1.
S ern to asd subscribed before me this g day of O U , Sworn to and subscribed before me this day of
Signature of Contractor / Qualifier
- Signature off. otaryTubH tateof ,Fl.rida Signature of Notary Public - State of Florida
11 p''' "6 e A i': t .
SEAL: ' 'll r SEAL:
0 �` II
PERMIT APPLICATION
Personally known OR, Produced Identification n Personally known OR, Produced Identification
Type of Identification Produced: 146 .5 ' 0 / r ' 9 ( . 2 0 Type of Identification Produced:
PERMIT APPLICATION FOR, MIAMI SHORES VILLAGE
Date / ) /6JobAress 2 $ 3 A/ I' /00 5 Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant N 4 C w
/ , Q )1 A i(ci A.
Owner's Address S 'z 'h C Phone (3 C - 7s -- - ' ? ?
- 7.s'7 /3 (.4..Y( Contracting Co. a N C ' Address
Qualifier SS# Phone
State # Municipal # _ _ Competency # Ins. Co.
Architect/Engineer _ Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 0" 4 i n / JT G gt 5 c �'
A9 tir ,oaf" /—
Square Ft. Estimated Cost (value) l( 7
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
RADON C.C.F.
Signature of Contractor or Owner- Builder Date
Master Permit #
No
3q7 g.'
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builde
My Corpmissior r,Y t � l A 6 r1 IAMV SSEM.
II ®F liaSi '(1 n.1f i� (ylymnan
= c? Cvllf ::1190 •ETSP.
NOTARY 5 TOTAL DUE
Date
APPROVED: ``
Zoning Building Id? 51%
` ^ Electrical
Mechanical Plumbing Engineering